Private Providers to Share Doctor Performance Worries With NHS

Peter Russell

October 23, 2019

A system is being developed so that information about the performance of health professionals can be shared between the NHS and the independent sector.

The framework was seen as a step towards a single unified platform where information about doctors could be centralised.

The governance framework was developed by Sir Bruce Keogh, former NHS national medical director, for the Independent Healthcare Providers Network (IHPN). The work was designed to improve the oversight of medical practitioners in the independent acute sector.

It followed the conviction of rogue breast surgeon Ian Paterson, who was jailed in 2017 for carrying out unnecessary surgery on female patients while working in a private capacity.

Conference Launch for New Framework

The Medical Practitioners Assurance Framework was launched today at IHPN's annual summit in London. It highlighted a number of key areas, including:

  • Creating an effective clinical governance structure for medical practitioners

  • Monitoring patient safety, clinical quality, and encouraging continuous improvement

  • Supporting whole practice appraisal

  • Raising and responding to concerns

"The key to excellent care is organisational support for the right clinicians with the right expertise to do a good job and having systems in place that spot when things are not going well," Sir Bruce said.

A key thread to the framework was developing a standard system for identifying and acting on concerns about any medical practitioner. It followed a 2018 report by the Care Quality Commission (CQC) that identified inconsistences in monitoring of medical governance, including scope of practice of individual consultants.

Over 29 independent providers, representing more than 200 individual sites, have signed up to implementing the new framework, the IHPN said.

Proving Effective Governance

David Hare, chief Executive of the IHPN, commented: "While the Care Quality Commission made clear in their report on independent acute hospitals last year that the overwhelming majority of care delivered in the sector is either good or outstanding, the sector was quick to act on their call for greater consistency around medical governance."

Heidi Smoult, deputy chief inspector of hospitals for the CQC, said: "While sign up to the framework is not mandatory or something CQC has the power to enforce, where providers can demonstrate effective and robust implementation of its principles, this will be considered as evidence of good governance and will inform the judgement we make about how well led services being provided by that organisation are."

The Royal College of Surgeons said it wanted all independent hospitals to sign up to the framework. "Every patient has the right to expect safe, high-quality care, no matter where they are treated," commented its President, Prof Derek Alderson. "We can only be confident of this if both the NHS and the independent sector collect and share information about the performance of their services, and the practitioners working within them."

Prof Carrie MacEwen, chair of the Academy of Medical Royal Colleges said: "Doctors need to be supported to provide safe, high quality care in all aspects of their professional lives.

"We therefore welcome this medical governance framework for the independent healthcare sector which does this in a systemic fashion by ensuring that all parties have secure mechanisms to work together to improve patient care in this setting."

The framework is due to be reviewed in late 2020 to ensure the principles remain in keeping with current best practice around medical governance in the health system.

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